The mediational effect of coherence on the relationship between mental load and job burnout among oncology nurses.

AIMS: The purpose of this study was to determine the mediational effect of coherence on the relationship between mental load and job burnout among oncology nurses. BACKGROUND: Working stress and strain cause high mental load and can lead to job burnout among oncology nurses. Sense of coherence protects against the negative consequences of occupational mental load and may prevent professional burnout. MATERIALS AND METHODS: The study was carried out with 165 oncology nurses from chemotherapy departments. The data were collected from April to September 2013 using the Antonovsky Sense of Coherence Scale, Meister questionnaire, and Maslach Burnout Inventory. RESULTS: Manageability mediated the relations between Mental Load and both Emotional Exhaustion and Depersonalization. Meaningfulness exerted significant mediational effect on the relationship between Mental Load and Depersonalization. Manageability and Meaningfulness attenuate the unfavourable effect of Monotony and Unspecific load on motional Exhaustion and Depersonalization. CONCLUSIONS: Sense of coherence, especially Manageability and Meaningfulness, seems to be an important resource for oncology nurses, buffering the negative impact of mental load on well-being of nurses. Strengthening the sense of coherence can be helpful in preventing or dealing with professional burnout.

Knowledge, compliance with good clinical practices and barriers to effective control of postoperative pain among nurses from hospitals with and without a "Hospital without Pain" certificate.

AIMS AND OBJECTIVES: (i) To compare knowledge and compliance with good clinical practices regarding control of postoperative pain among nurses employed at hospitals with and without a "Hospital without Pain" certificate, (ii) to identify the determinants of nurses' knowledge and (iii) to define barriers to effective control of postoperative pain. BACKGROUND: Only a slight improvement in postoperative pain control has been observed recently, if any. Implementation of good clinical practices in the control of postoperative pain requires involvement of nurses. DESIGN: A cross-sectional study. METHODS: The study included 257 nurses from hospitals with a "Hospital without Pain" certificate and 243 nurses from noncertified hospitals, with mean job seniority of 17.6 ± 9.6 years. All respondents answered 26 questions regarding postoperative pain control-related issues. Based on the answers, overall scores were calculated for (i) nurses' knowledge, (ii) compliance with good clinical practices and (iii) barriers to effective control of postoperative pain. RESULTS: Nurses from the certified hospitals presented with significantly higher levels of knowledge and compliance with good clinical practices and identified significantly more barriers to effective control of postoperative pain. Apart from certification of a hospital, better knowledge of postoperative pain control was determined by higher education, participation in postgraduate training programmes and other relevant courses, self-education from medical journals, employment at paediatric ward or intensive care unit. The most commonly reported barriers to effective control of pain included too low doses of painkillers prescribed by physicians and inability to modify the protocol of pain treatment by the nurse. CONCLUSIONS: Control of postoperative pain can be improved by enrolling nurses in various forms of continuous training and by providing them with greater autonomy in administering painkillers to surgical patients. RELEVANCE TO CLINICAL PRACTICE: Better quality of care offered to patients with postoperative pain can be achieved by continuous education of nurses and physicians, and greater compliance with relevant good clinical practices.

Perceived social support and the sense of coherence in patient-caregiver dyad versus acceptance of illness in cancer patients.

BACKGROUND: Acceptance of illness is a significant determinant of further coping with a disease. Development of illness acceptance may be associated with the sense of coherence and perception of social support. Cancer is an example of a crisis situation, which affects both the patient and his/her close relatives. Consequently, acceptance of illness may be influenced by factors originating from both sides of caregiver-patient dyad. The aim of this study was to analyse direct and indirect interrelationships between perceived support and the sense of coherence in patient-caregiver dyad, and acceptance of illness in cancer patients. DESIGN: Cross-sectional study. METHODS: The study included 80 dyads composed of cancer patients and their caregivers. Only cancer patients undergoing oncological treatment at the time of the study, for at least 3 months but no longer than 12 months, were enrolled. All subjects completed perceived support subscale included in the Berlin Social Support Scales, sense of coherence-29 questionnaire to determine the sense of coherence and Acceptance of Illness Scale. RESULTS: Compared to cancer patients, their caregivers presented with significantly lower levels of perceived social support and weaker sense of coherence. The sense of coherence in caregivers and patients was determined by their perceived support levels. The sense of coherence in caregivers turned out to be a key resource influencing acceptance of illness in cancer patients, both directly and indirectly, via their perceived social support and their sense of coherence. CONCLUSIONS: The sense of coherence, an intrinsic psychological factor determined by social support, is an important determinant of illness acceptance. Functioning of cancer patients is also modulated by psychosocial characteristics of their caregivers. RELEVANCE TO CLINICAL PRACTICE: Greater support offered to caregivers may substantially strengthen the sense of coherence in caregivers and cancer patients and, therefore, may improve the functioning of patient-caregiver dyad in a situation of neoplastic disease.

Sense of Coherence vs. Mental Load in Nurses Working at a Chemotherapy Ward.

OBJECTIVE: The aim of this study was to analyze the relationship between the sense of coherence and the level of mental load among nurses working at a chemotherapy ward. METHODS: The study, conducted in 2013, included 164 nurses working at inpatient chemotherapy wards in Krakow, Poznan, Kielce, and Gliwice (Poland). The mean age of the study participants was 43.07±7.99 years. The study was based on a diagnostic survey with Antonovsky's Sense of Coherence Scale (SOC-29) and Meister questionnaire. RESULTS: The levels of Mental Load, Monotony and Unspecific Load, correlated inversely with the levels of Coherence, Manageability, Meaningfulness, and Comprehensibility. Longer work experience was associated with lower levels of Coherence, Manageability and Comprehensibility and higher levels of Mental Load, Overload and Monotony. Age of nurses correlated inversely with the Manageability level. Heavy mental and physical workload turned out to be the main factor causing dissatisfaction of the study participants. CONCLUSIONS: Longer work experience and lower levels of Coherence are associated with higher risk for mental overload.

Quality of life in patients with cystic fibrosis depending on the severity of the disease and method of its treatment.

INTRODUCTION: Quality of life is a measure not only of disease severity and its functional impact (physical, psychological, and social functioning) but also the efficacy of novel therapies. The aim of this study was to analyze the quality of life in cystic fibrosis patients depending on the severity of the disease and methods of its treatment. MATERIAL/METHODS: The study included groups of cystic fibrosis patients: 1) after lung transplantation, 2) requiring chronic oxygen therapy, and 3) in stable clinical status. Forty-five men and women older than 18 years were enrolled. The participants were examined with the Polish version of the Cystic Fibrosis Quality of Life Questionnaire (CFQoL) adapted by Debska & Mazurek. RESULTS: Patients from analyzed groups differed significantly in terms of their quality of life in most of the subscales included in CFQoL, but not in Future Concerns and Interpersonal Relationships. DISCUSSION: Although lung transplantation markedly improves the quality of life of patients with cystic fibrosis, they still experience problems with social functioning and future concerns.

Health-related quality of life of patients with cystic fibrosis assessed by the SF-36 questionnaire.

INTRODUCTION: Cystic fibrosis (CF) is a genetic disorder, which is most common among Caucasians. There are about 100,000 people suffering from this disorder in the world, including 25 000 in Europe. Although the first mention of cystic fibrosis is thought to have occurred in 1595, recognition of the entire clinical spectrum of CF and the resultant development of contemporary knowledge occurred in the 20th century. In the past, CF was considered a fatal childhood disorder; however, contemporary statistical data shows that 50% of people with cystic fibrosis have a chance to live up to 30 years of age, and the lifespan of children born in the 1990s is projected to be at least 40 years. Consequently, the number of adults with cystic fibrosis is increasing, making it necessary for multidisciplinary actions aimed at the improvement of clinical management of the condition as well as minimizing the influence of CF and its treatment on the quality of continually extending life of patients. Since cystic fibrosis interferes with almost all important aspects of human functioning, quality of life (QoL) of individuals with CF should be constantly and closely monitored, thus allowing for consideration of their needs and providing an opportunity to modify the therapeutic approach if necessary. The aim of this study was to visualize the QoL of people with cystic fibrosis, to identify differences in their assessment of QoL depending on sex and age, as well as to compare the QoL of patients with CF with a control group of people without CF. MATERIAL AND METHODS: The study was conducted among patients hospitalized at the Clinic of Pulmonology and Cystic Fibrosis at the Institute of Tuberculosis and Lung Diseases in Rabka-Zdrój from February to April 2012. The study encompassed 30 patients (19 women and 11 men), aged between 16 and 42 years, with acute episodes of bronchopulmonary disease. A Short Form-36 (SF-36) questionnaire was used to evaluate the health-related quality of life. The control group encompassed 30 healthy individuals with the same sex ratio and similar age ratio as in the group of patients. RESULTS: The analysis of quality of life with the use of the SF-36 questionnaire showed that in general the quality of life of the assessed patients was low. The patients scored on average below 50 in the following subscales: Role Physical (RP), General Health (GP), Vitality (VT), Social Functioning (SF), Physical Component Summary (PCS) and Mental Component Summary (MCS). In other subscales the results slightly exceeded 50. In women, low quality of life was found in the following subscales: Role Physical, Bodily Pain (BP), General Health (GH), Vitality (VT), Social Functioning (SF), Physical Component Summary (PCS) and Mental Component Summary (MCS). In men, average results below 50 were found in the following subscales: General Health (GH) and Vitality (VT). Moreover, in all subscales, the quality of life assessed by women was lower than that reported by men.Patients > 25 years assessed their quality of life as lower in all subscales except for the Role Emotional (RE) subscale. Statistically significant differences were identified with regards to Vitality (VT) and Mental Health (MH). The analysis of the influence of CF patients' age on their quality of life, conducted with the use of the SF-36 questionnaire, showed that there were statistically significant correlations (p < 0.05) between age and the following domains: Physical Functioning (PF), Role Physical (RP), Bodily Pain (BP), Vitality (VT), Social Functioning (SF), Mental Health (MH) and Physical Component Summary (PCS). The comparison between the QoL of patients with CF and those of a control group of individuals not suffering from CF demonstrated that there were statistically significant differences in all subscales. Patients' quality of life was significantly poorer than quality of life of individuals without CF. CONCLUSIONS: 1. Patients with CF generally perceive their quality of life as low.2. There are differences in the assessment of quality of life between women and men.3. The older the patients, the worse their quality of life assessment in most subscales.4. There are critical differences in the quality of life assessment between patients with CF and a control group encompassing individuals without CF. Patients with CF find their quality of life poorer.

Personal Resources and Expectations and Health Behaviors Among Solid Organ Transplant Recipients-A Multicenter Study.

BACKGROUND: The long-term success of organ transplantation (Tx) depends on the transplant recipient's ability to self-manage symptoms, treatment, lifestyle changes, and psychosocial consequences. Health behavior (HB) determinants include personality traits such as optimism, self-efficacy, and health locus of control. PURPOSE: Assessing the relationship between personal resources and expectations and health behaviors of organ transplant recipients. MATERIAL AND METHODS: The study was conducted between 01/04/2018 and 30/10/2019 at 3 transplant centers in Poland. The study group consisted of 243 Tx recipients of kidney, heart, liver, and lung. The Health Behavior Inventory, Multidimensional Health Locus of Control Scale (MHLC), General Self-Efficacy Scale, Dispositional Optimism Scale, and Hospital Anxiety and Depression Scale were used to collect data. FINDINGS: The study group had medium levels of dispositional optimism (mean 15) and high levels of self-efficacy (mean 30.18). The MHLC scale was dominated by a belief in the influence of others and an internal locus of control over one's health. The respondents presented a high level of HB (mean 92.09). A positive relationship was found between personal resources (self-efficacy and optimism), MHLC and HB. The presence of depression and anxiety negatively affected personal resources and internal locus of health control and HB in terms of a positive mental attitude. Type of Tx differentiated internal locus of health control and HB. Predictors of HB were dispositional optimism, self-efficacy, influence of others with health locus of control, symptoms of depression, age and time since transplantation-explaining between 6.1% and 14.5% of health behavior categories. CONCLUSIONS: To improve health practices among organ recipients, strengthening their personal resources is recommended. It is necessary to form an internal locus of control for adherence to positive HB.

Knowledge and Attitudes of Dialysis Patients Toward Kidney Transplantation: Preliminary Report from a Pilot Study Preceding a Cross-Sectional Nationwide Evaluation.

BACKGROUND: The knowledge and attitudes of dialyzed patients toward the best method of renal replacement treatment (ie, kidney transplantation [KTx]) may be the main factor motivating them to apply and be put on the national kidney transplant waiting list, resulting in a better prognosis. OBJECTIVE: Assessment of the knowledge and attitudes of dialyzed patients toward KTx. METHODS: A pilot study is considered an introductory step before the nationwide project, which will cover dialysis centers in Poland from 2023 to 2024. The authorship 4-part questionnaire, including self-assessment knowledge, attitude dimension, pain and mental evaluation section, was made available to 30 patients with hemodialysis aged 30 to 75 years. RESULTS: The median age of the patients was 59 years. The primary cause of end-stage renal disease (ESRD) was glomerulonephritis (33%). Most of the patients stayed on hemodialysis for 2 years or less (57%); 43% of the patients declared insufficient knowledge in the field of KTx, 41% of the patients were not informed at the nephrology clinic that KTx remains one of the methods of renal replacement therapy, and 65% did not receive information about the possibility of preemptive or early transplantation from a relative donor. Only 34% of the patients considered KTx to be a much better treatment option than dialysis, but only 20% of those were on the national waiting list for KTx. CONCLUSIONS: The pilot study showed insufficient knowledge of patients with ESRD regarding kidney transplantation as a method of renal replacement therapy. There is a need to introduce an effective educational program.

[Psychometric properties assessment of the Meister questionnaire (Polish version) used in evaluating mental load among nurses]. / Ocena wlasnosci psychometrycznych polskiej adaptacji kwestionariusza meistera do oceny obciazenia psychicznego w pracy pielegniarki.

BACKGROUND: The objective of this study was to assess psychometric properties of the Polish version of the Meister questionnaire for subjective assessment of work-related mental load among nurses. MATERIAL AND METHODS: A group of 211 nurses (mean age, 43.1 +/- 7.26) participated in our study. In the process of adaptation stability (test-retest) reliability and factorial validity were assessed. The Maslach Burnout Inventory (MBI) was used as a tool for assessing construct validity). RESULTS: Factor analysis of the questionnaire confirmed a very good fit between input data and factor model (Kaiser-Mayer-Olkin measure of 0.83). Selected variables, including overload, monotony, and non-specific load, explained 57%, 41%, and 66% of the variance, respectively. The analysis proved high validity of the tool, Cronbach alpha was 0.83 for the total score. The correlation factor for questions and scores in subscales was high. Repeated measurements resulted in similar outcomes, which proved the stability of this measure. The analysis of construct validity showed that overload, monotony, and non-specific load presented positive correlation with emotional exhaustion and depersonalisation. Correlation between variables was moderate (rHO = 0.39-0.58; p < 0.001). 'he total score indicated the following correlations: strong positive with emotional exhaustion (rHO = 0.6, p < 0.001), negative with personal achievements, and positive and moderate with depersonalisation (rHO = -0.14; p < 0.05, rHO = 0.48; p < 0.001). CONCLUSION: The Polish version of the Meister questionnaire meets all psychometric criteria and may be used for evaluating mental load among nurses.

Polish validation of the Transplant Effects Questionnaire.

Introduction: The Transplant Effects Questionnaire (TxEQ) assesses specific recipients' reactions to receiving a transplanted organ, including worry about the transplant, Guilt regarding the donor, disclosure of having undergone transplantation, adherence to medical treatment, and responsibility to the donor, family, or medical staff. Poland has no standardized tool for evaluating the emotional reaction to transplantation. The study aimed to assess the basic psychometric properties, such as the reliability and validity of the Polish translation of TxEQ-PL. Materials and methods: The study involved 84 patients after kidney transplantation. The average age of the subjects was 49.87 years (±15.27). The study used the diagnostic survey method, the Polish versions of the Revised Life Orientation Test (LOTR-R), the Mental Component Summary of the SF-36 (SF-36-MCS), and the Hospital Anxiety and Depression Scale (HADS). The Confirmatory Factor Analysis (CFA) was used to verify the factor structure of TxEQ -P.L. variables. Results: The TxEQ-PL version has satisfactory internal consistency for each subscale (Cronbach's alpha > 0.7). The analysis showed a significant negative relationship between optimism (LOT-R) and the TxEQ-PL subscales: worry about transplant and disclosure of having undergone transplantation and a positive relationship in the subscale of adherence to medical treatment. In addition, a significant negative relationship was found between the subscale: adherence to medical treatment and the severity of depression and intensity of anxiety (HADS); also, a positive relationship with the Mental Component Summary of the SF-36 (SF-36-MCS). The intensity of anxiety and severity of depression were positively related to the TxEQ-PL subscale of disclosure of having undergone transplantation and negatively associated with the Mental Component Summary of the SF-36 (SF-36-MCS). The Confirmatory Factor Analysis confirmed the five-factor structure of the TXEQ-PL questionnaire (RMSEA = 0.083). Not the best fit is indicated by the value of comparative fit indexCFI = 0.813 and SRMR = 0.10. The result of the chi-squared test (220) = 340 was statistically significant; p < 0.001. Conclusion: TxEQ-PL is useful for assessing emotional reactions to organ transplantation. The tool has a factor structure identical to the original English version and comparable psychometric properties.

Patient's perception of the meaning of life in cystic fibrosis--its evaluation with respect to the stage of the disease and treatment.

INTRODUCTION: Cystic fibrosis (CF) is related to physical and mental barriers. The objective of this work was to evaluate and compare patients' perception of sense of life in cystic fibrosis in different stages of their disease and therapeutic methods. MATERIAL/METHODS: The study group included 45 patients divided into 3 subgroups: after lung transplantation, waiting for lung transplantation and with cystic fibrosis in stable condition. The evaluation and comparison of patient's perception of sense of life and purpose of life was performed with the Purpose in Life Test. RESULTS: All patients with CF felt their lives were meaningful and purposeful. However, their pursuits for designated aims depended on the progression of their disease. CONCLUSIONS: CF with its poor prognosis has a significant impact on patient's hierarchy of respected values and life priorities. High level of acceptance for suicidal behaviours observed in all diagnostic subgroups of patients with CF indicates a need for organized intensified psychological care.

Health Locus of Control and Health Behaviors in Organ Transplant Recipients: A Multicenter Study.

BACKGROUND: Adherence to health behaviors and to immunosuppressant medications are variables among heart transplant recipients with potential life-threatening outcomes. It is understood that patients with psychosocial barriers are at increased risk of poor outcomes due to various factors. Health locus of control includes any activity that can be done to prevent health problems. Health locus of control is defined as individual beliefs based on past experiences in health issues and having internal and or external control. The literature suggests that patients with a strong internal locus of control have a sense of responsibility for their health behaviors. PURPOSE: To investigate the effect of the health locus of control on the level of self-reported health behaviors among organ transplant recipients. MATERIALS AND METHODS: A cross-sectional design was used for this study. The study group comprises 222 individuals after heart, kidney, lung, and liver transplantation. The following standardized tools were used: The Multidimensional Health Locus of Control, The Health Behavior Inventory, Morisky Medication-Taking Adherence Scale 4-item. Data were analyzed using IBM SPSS. The level of significance for the statistical test was set at 0.05. RESULTS: Powerful Others scored the highest among the 3 Health Locus of Control scales in heart, kidney, and liver recipients. Participants paid little attention to Healthy eating habits; however, the total score of the Health Behavior Inventory was high (91.68-94.40). There was a difference between the kind of transplant and center for 4 aspects of health behavior. Higher scores of The Multidimensional Health Locus of Control were associated with higher scores of Health Behaviors and level of adherence. Greater Powerful Others and Internal Health Locus of control predict higher health behaviors explaining 42 % of the variance. CONCLUSIONS: The intensification of declared health behaviors is high. However, in educating posttransplant patients, attention should be paid to strengthening proper healthy eating habits. Associations between health locus of control dimensions and health behavior have been shown among transplant recipients. The health locus of control significantly predicts the intensity of health behaviors. these findings support the need to consider health control beliefs while designing preventive strategies in this group of patients.

[The perception of the purpose and sense of life among cystic fibrosis patients after lung transplantation]. / Postrzeganie zycia, jego celu i sensu przez chorych na mukowiscydoze po przeszczepie pluc.

Patients with cystic fibrosis keep struggling with their disease despite the improvement of their lung function after lung transplantation. Also, they often have to define and verify their purpose and sense of life once again. Therefore, an attempt to search answers to the questions: what health is, what one is expecting form his/her life, and what value this life after lung transplantation has for him/her; seems significant.

Continuous professional development of nurses and ICNP® introduction in Poland.

OBJECTIVES: The aim of the study was to explore Polish nurses' readiness to use the International Classification for Nursing Practice (ICNP®) as part of continuous professional development and life-long learning. MATERIAL AND METHODS: The study included 772 nurses, divided into 2 study groups. The first group comprised those who had participated in a course enhancing the knowledge and improving skills in the use of ICNP® terminology (N = 457). The second group comprised people who had not yet attended such a course (N = 315). RESULTS: In the pre-course group, education correlated significantly with a general knowledge of ICNP® and its components, as the answers to 9 out of 13 questions revealed (p > 0.05). In the postcourse group, such a correlation was observed in the answers to all the questions except the following: "Is it possible to implement ICNP® in your place of work?" (ρ = 0.066, p = 0.137). Statistically significant differences were found when it comes to the correlation of all 13 questions and the results with the overall level of knowledge of ICNP®. A higher level of agreement with the questions and a higher level of knowledge were observed in the post-course group. However, this did not apply to the following question: "Is it possible to implement ICNP® in your place of work?" (Z = -0.06, p = 0.955, r = 0.002). CONCLUSIONS: Effective pre- and postgraduate education prepares nurses for working with ICNP® terminology. In fact, IT tools, implemented into the education process, could help to develop skills and the understanding of how nurses can use ICNP® in the nursing process. There are some obvious difficulties with the practical implementation of ICNP® into clinical practice. Int J Occup Med Environ Health. 2020;33(3):353-63.

The Quality of Life as a Predictor of Social Support for Multiple Sclerosis Patients and Caregivers.

BACKGROUND: Coping with a diagnosis of multiple sclerosis (MS) is challenging. MS is one of the most common causes of nontraumatic disability in young adults, and patients may need assistance with daily life activities. This article explores the relation between quality of life (QOL) and the perceived available social support among patients with MS and their families. METHODS: The study included 120 subjects (60 patient-caregiver dyads). The average age of the patients was 53.95 ± 10.19 years, and for caregivers, it was 50.8 ± 13.3 years. The study used 2 subscales of the Berlin Social Support Scale (perceived availability of social support and need for social support) and the World Health Organization Quality of Life questionnaire for the assessment of QOL. RESULTS: QOL in MS is lower compared with that of their caregivers in all dimensions except the social domain (P < .001, r = 0.54-0.64). A higher need for social support was experienced by caregivers. The need for support in this group is affected by 3 predictors: QOL in the environmental domain and in the physical domain as well as their subjective health. An improvement in QOL in all the domains is related to an increase of perceived available support, in both the group of patients and that of their caregivers (P < .05, ρ = 0.28-0.59). CONCLUSIONS: Perceived available support is of great importance for both patients and their caregivers to enable them to function better in the physical, mental, social, and environmental domains of their QOL, where social relationships play a predictive role.

Analysis of the health situation of women referring to breast cancer screening in Poland.

PURPOSE: To analyze the health situation of women referring to breast cancer screening. METHODS: The study was conducted at "Certus" Medical Center in Myslenice (Malopolska Province). A total of 808 women aged 51-69 years were enrolled. The protocol of the study was approved by the administration of the medical center where it was conducted. The survey consisted of 24 descriptive and single/multiple choice questions referring to health behaviors related to breast cancer prevention. RESULTS: Most often the women received information about breast cancer prevention from specialist physicians [24%]. Only 14% of the participants reported radio, press and Internet as an important source of information. Only 12% of the respondents declared that they self-examined their breasts systematically every month, and 35% stated that their breasts had been examined by a physician during recent years. A statistically significant relationship was found between the primary source of information about breast cancer prevention and the educational level of the study participants (p=0.0008). CONCLUSIONS: Considering the Polish Central Statistical Office estimates, according to which the proportion of persons older than 65 years is projected to grow up to 22.3% by 2030, we may expect further increase in breast cancer incidence. Improvement of the epidemiological situation in Poland, which is worse than in other European countries, requires continuation of multidirectional activities, among them population-based education and active screening.

Level of Life Quality in Heart and Kidney Transplant Recipients: A Multicenter Study.

OBJECTIVE: The main objective of the researchers was to determine the level of life quality among heart and kidney transplant recipients depending on the time and type of the transplant. METHODS: The study was conducted using standardized questionnaires: the 36-Item Short-Form Health Survey, Life Orientation Test-Revised, and Hospital Anxiety and Depression Scale. The study included 146 recipients (109 heart transplant recipients and 37 kidney transplant recipients) from 1 to 26 years after the transplantation surgery (mean 9 years). RESULTS: The mean age of the study group was 52 years. The mean time since organ transplantation was 10 years for heart transplantation and 4.3 years for kidney transplantation. The study group obtained a slightly lower score for quality of life compared to the general population. In the Physical Component Summary (PCS), the study participants obtained the highest mean for the domain bodily pain (47.6), while the lowest score was in the domain role physical (41.82). As for the Mental Component Summary (MCS), the highest mean was obtained for the domain vitality (50.57), whereas the lowest one was for the domain role emotional (43.38). In 33% of the participants, risk of depression was identified. Statistically significant differences were observed depending on the type of the transplanted organ in the PCS for the domains general health, physical functioning, and bodily pain and the MCS for role emotional and social functioning. The statistically significant predictors for the PCS domain were the type of transplanted organ, recipients' age, and occurrence of anxiety. In turn, the predictor for the MCS was the occurrence of depression. CONCLUSIONS: The quality of life (QOL) assessment varies between kidney and heart transplant recipients. The QOL is determined by the recipients' age and the occurrence of anxiety and depression. The obtained QOL assessment results are slightly lower than those in the general population.

Evaluation of quality of life predictors in adolescents and young adults with cystic fibrosis.

BACKGROUND: Cystic fibrosis (CF) is a chronic disease that has an impact on Health-Related Quality of Life (HRQoL). OBJECTIVES: To identify demographic and clinical factors associated with HRQoL in adolescents and young adults with CF. METHODS: The sample comprised adolescent and young adult patients with CF. They completed the Cystic Fibrosis Quality of Life (CFQoL) questionnaire, which includes Physical, Social, Treatment, Chest Symptoms, Emotional Functioning, Future Concerns, Relationships, Body Image, and Career dimensions. We examined the relationships between gender, age, body weight, FEV1, pain, sleep, anxiety, depression and HRQoL. RESULTS: The sample comprised 95 patients (aged 14-25 years; female/male: 43.1/56.8%). The lowest CFQoL score was observed in Future Concerns. FEV1 and body weight were positively associated with Physical Functioning (ß = 0.21; P < 0.01) and Body Image (ß = 0.30; P< 0.01), respectively. Females perceived themselves more negatively in Future Concerns (ß = -0.26; P< 0.01), Relationships (ß = -0.17; P< 0.01) and Career Concerns (ß = -0.20; P < 0.01) than males. Pain intensity (ß = -0.37), anxiety (ß = -0.39) and poor sleep quality (ß = -0.21) were negatively associated with global CFQoL (P < 0.001). CONCLUSIONS: Pain intensity, anxiety and quality of sleep have the broadest impact on HRQoL. Regular assessment of psycho-emotional functioning, quality of sleep and pain intensity may improve a patient's well-being.

[CFQoL questionnaire as an assessment tool of quality of life in patients with cystic fibrosis]. / Kwestionariusz CFQoL jako narzedzie oceny jakosci zycia chorych na mukowiscydoze.

The number of studies assessing quality of life, QOL, in patients with cystic fibrosis is quite small in world's and Polish literature, when compared with explosion of research concerning that topic in other disorders of the respiratory system. It is due to the fact that usage of general questionnaires or measures specific for other respiratory diseases turns out to be insufficient in the case of cystic fibrosis. Therefore, studies aimed at development and utilization of specific quality of life measures in cystic fibrosis are recommended. In this paper, quality of life measurement tools in cystic fibrosis and rules of their application are presented. Attention was paid to CFQoL, English questionnaire by Gee et al., which was validated as a quality of life measurement tool in cystic fibrosis (adults and adolescents). CFQoL, which Polish research proved to be a reliable tool as far as its psychometric parameters were concerned, was characterized here.

[Validation of Polish version of CFQoL in patients with cystic fibrosis]. / Walidacja polskiej wersji kwestionariusza jakosci zycia u chorych na mukowiscydoze (CFQoL).

UNLABELLED: Cystic Fibrosis Quality of Life Questionnaire (CFQoL), is a specific measurement tool of quality of life in adolescents and adults with cystic fibrosis, fully verified in English-speaking countries. However, introduction of new language version requires validation process. The aim of this study was to validate Polish version of CFQoL questionnaire. MATERIAL AND METHODS: Language adaptation was performed after obtaining consent of the author. Healthy group (n=40, mean age = 19.5 +/- 3.4 years) assessed level of comprehension of each questionnaire item. Final Polish version of the questionnaire was assessed in 33 patients with cystic fibrosis (mean age = 21.8 +/- 3.4 years). The comparisons included CFQoL, SGRQ, WHOQOL-BREF, HADS and medical records analysis (spirometry, Shwachman-Kulczycki scale). RESULTS: CFQoL questionnaire was well understood and its graphics and time of completion were highly assessed. Good reliability of CFQoL was proven: Cronbach's Alpha coefficient was over 0.7 for all subscales, and high correlations between each item and general outcome for every subscale were found (r = from 0.63 to 0.93; p < 0.001). High correlation was observed in measurements repeated after 3 to 4 days (r = from 0.66 to 0.93; p < 0.001), the only difference between assessments was reduction of concerns about future (p = 0.007). Accuracy of the questionnaire was proven by significant correlations between CFQoL subscale assessing physical functioning and general outcome of SGRQ, psychosocial aspect of CFQoL and WHOQOL-BREF subscales, and emotional functioning subscale of CFQoL and anxiety and depression in HADS scale. There were no relationship between clinical data and CFQoL except Shwachman-Kulczycki scale. CONCLUSION: Polish version of the questionnaire fulfilled basic psychometric criteria and may be used for evaluation of quality of life of adolescents and adults with cystic fibrosis.